http://www.bbc.com/news/health-59378849
Covid: Can UK avoid a Europe-style return to lockdown?
Nick Triggle
Health correspondent
@nicktriggleon Twitter
Published14 hours agocommentsComments
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Coronavirus pandemic
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Covid infection rates have started rising sharply in parts of Western
Europe, prompting the introduction of fresh restrictions and lockdowns.
It has triggered fears the UK could follow suit. But there are plenty of
reasons to believe Britain will escape the worst of what is being seen
on the continent. In fact, the UK may well be in the strongest position
of all to weather Covid this winter.
To understand why that could be the case, you need to look at the
reasons why cases have started to take off in Western Europe.
Unlike the UK - and England in particular - many parts of Europe kept
major restrictions in place for much longer.
Whereas England fully unlocked in mid-July, parts of Europe did not do
this until the autumn, and in many places kept tougher restrictions in
place even as they did.
Part of this was to do with timing. The UK was hit by the more
infectious Alpha variant and then Delta sooner, meaning it was in a
position to push ahead with unlocking before others.
Chart showing infection rates
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Chart showing Covid deaths
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But it was also a conscious choice backed by the government's top
scientists, Prof Chris Whitty and Sir Patrick Vallance.
The logic - along with the benefit of ending restrictions that
themselves cause harm to health - was that it was better to have the
rebound in infection, the so-called exit wave, in the summer.
It was felt the increase in the spread of the virus would be mitigated
by the better weather, meaning more time spent outdoors, and would avoid
the winter crunch when pressure on the health system increases across
the board.
UK has high levels of immunity
The UK has, in effect, already had the wave the rest of Europe is seeing
and has managed to avoid being swamped by it.
That is mainly because of the amount of immunity built up.
A combination of good vaccine rollout, particularly among the older more
vulnerable groups who are the ones most at risk of serious illness, and
natural immunity from infection means there is likely to be a much
smaller pool of vulnerable people for the virus to infect.
Researchers at the London School of Hygiene and Tropical Medicine have
been trying to quantify this by looking at what would happen if everyone
was suddenly exposed to the virus in one go.
They modelled this for England - although there is nothing to suggest
Scotland, Wales and Northern Ireland would be any different - and 18
other European nations.
If this hypothetical situation happened, England would have by far the
fewest people ending up in hospital - 62 per 100,000 people - because of
immunity built up by vaccination and infection. That compares with more
than 300 in Germany, largely because of their lower levels of infection
to date, and more than 800 in Romania, which has struggled to convince
its public to come forward for vaccination.
Chart showing modelling of hospital cases
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This was the picture at the end of October. If the same analysis was
done at the end of November it is likely the situation would be even
more favourable for England, says lead researcher Dr Lloyd Chapman.
That's because the UK is ploughing ahead faster than other nations with
boosters. Again part of this is related to timing. As the UK was quicker
off the mark with Covid vaccinations initially, there are greater
numbers of people becoming eligible for a booster.
"We are giving those boosters to the very people who are most at risk at
perhaps the best time - they will have the best protection in winter."
Chart showing booster uptake
Presentational white space
But Dr Chapman also points out this has come at a price - the high rates
of infection have resulted in a greater amount of serious illness and
death in recent months than many of our Western European neighbours.
And he adds the research should not be seen as a guarantee we will
escape the winter without seeing a surge in cases. "We may be in the
strongest position - but we could still see cases double and that would
cause problems."
'Public playing key role in UK'
But is that likely? What is perhaps most remarkable about the UK is just
how stable infection levels have been. Ever since the sharp rise seen in
early summer peaked in mid-July, infection rates have bobbled along,
small rises being followed by similar drops.
There is no other part of Europe that has seen Covid infections held so
stable with very few restrictions in place.
Instead, when other nations have seen cases surge restrictions have
tended to be reimposed. This is happening now in parts of Western Europe
and follows on from what happened in Eastern Europe early in the autumn.
Romania, for example, saw a sharp rise in cases in September and October
and reacted by introducing a night curfew, sending children home from
school and introducing health passes for access to public venues.
It is telling that those nations that have had the most problems as
winter arrives are the ones identified by the London School of Hygiene
and Tropical Medicine as having the greatest pool of vulnerable people.
How far this pattern spreads across Europe remains to be seen.
Doctor administering injection to young woman
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But immunity alone does not explain why the UK, and in particular
England, has seen such stable rates, says Prof Graham Medley, who chairs
the government's infectious disease modelling group.
Prof Medley, speaking in a personal capacity, believes it is more
complex than that. "I think we are seeing the public playing an
important role."
He says a combination of limiting mixing and frequent use of rapid
tests, which are more easy to access here than in many other countries,
seems to be doing just enough to keep the virus in check.
"The government has passed the risk management to the public - and we've
been able to do that better than other countries."
The big question is whether that will last throughout winter - Scotland
and Northern Ireland are already talking about the possibility of
tightening of restrictions. Prof Medley says it is "delicately"
balanced, but with every passing week the chances are getting better.
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